Splenic infarct

Presentation

Patient Data

CT Abdomen and pelvis

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Axial C+ portal venous phase

The spleen is enlarged measuring 14 cm in craniocaudal length. There is a low-density lesion within the superior aspect of the spleen, affecting approximately one-third of the parenchyma likely consistent with a splenic infarct.

The interpolar region of the right kidney demonstrates some loss of volume with calcification likely consistent with chronic scarring.

The renal pelvis on the right may be partially extrarenal. The left kidney is unremarkable.

The liver demonstrates homogeneous enhancement with no focal liver lesion.

Case Discussion

The appearances are in keeping with a segmental splenic infarction: a wedge-shaped low-attenuation/non-contrasting area. The images are unequivocal about the diagnosis, although the main differentials to consider are a splenic laceration, particular in the setting of trauma, and, heterogeneous arterial phase enhancement of spleen.